Provider Demographics
NPI:1285156802
Name:UNDERWOOD, CAITLIN MARIE (MSOT, OTR/L)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:MARIE
Last Name:UNDERWOOD
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4413 COX RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-3326
Mailing Address - Country:US
Mailing Address - Phone:803-386-0485
Mailing Address - Fax:
Practice Address - Street 1:4413 COX RD
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-3326
Practice Address - Country:US
Practice Address - Phone:803-386-0485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-14
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119-007405225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics